FORM - TAX CLUB INDIA



Government of India | |

|[pic] |

|INCOME-TAX DEPARTMENT |

|ACKNOWLEDGEMENT |

|Received with thanks from a return of income and/ or return of fringe benefits in Form No. ITR 4 for assessment year 2009-10, having the |

|following particulars. |

|PERSONAL |Name |PAN |

|INFORMATIO| | |

|N | | |

| |Flat/Door/Block No |Name Of Premises/Building/Village |

| | | |

| |Road/Street/Post Office |Area/Locality |

| | | |

| |Town/City/District |State |Status (fill |

| | | |the code) |

| | | | |

| |Designation of Assessing Officer (Ward/ Circle) | |Original or Revised | |

|COMPUTATIO|1 |Gross total income |1 | |

|N OF | | | | |

|INCOME | | | | |

|AND TAX | | | | |

|THEREON | | | | |

| |2 |Deductions under Chapter-VI-A |2 | |

| |3 |Total Income |3 | |

| |3a |Current Year loss (if any) |3a | |

| |4 |Net tax payable |4 | |

| |5 |Interest payable |5 | |

| |6 |Total tax and interest payable |6 | |

| |7 |Taxes Paid | |

| | | | |

| | | | |

| | |a |Advance Tax |7a | | |

| | |b |TDS |7b | | |

| | |c |TCS |7c | | |

| | |d |Self Assessment Tax |7d | | |

| | |e |Total Taxes Paid (7a+7b+7c+7d) |7e | |

| |8 |Tax Payable (6 – 7e) |8 | |

| |9 |Refund (7e - 6) |9 | |

|COMPUTATIO|10 |Value of Fringe Benefits |10 | |

|N OF | | | | |

|FRINGE | | | | |

|BENEFITS | | | | |

|AND TAX | | | | |

|THEREON | | | | |

| |11 |Total Fringe Benefit Tax liability |11 | |

| |12 |Total interest payable |12 | |

| |13 |Total tax and interest payable |13 | |

| |14 |Taxes paid | |

| | |a |Advance Tax |14a | | |

| | |b |Self Assessment Tax |14b | | |

| | |c |Total Taxes Paid (14a + 14b) |14c | |

| |15 |Taxes Payable (13 - 14c) |15 | |

| |16 |Refund (14c - 13) |16 | |

|Receipt No |Seal and Signature of receiving Official |

|Date | |

| | |

| | |

|FORM |ITR-4 |INDIAN INCOME TAX RETURN |Assessment Year |

| | |(For individuals & HUFs having income from a proprietory business or profession) | |

| | |(Please see Rule 12 of the Income-tax Rules, 1962) | |

| | |(Also see attached instructions) | |

| | |

|PERSON|First name |Middle name |Last name |PAN |

|AL | | | | |

|INFORM| | | | |

|ATION | | | | |

| | | | | |

| |Flat/Door/Block No |Name Of Premises/Building/Village |Status (Tick) ( |

| | | | |Individual | |HUF |

| |Road/Street/Post Office |Area/Locality |Date of Birth (DD/MM/YYYY) |

| | | |(in case of individual) |

| | | | |

| |Town/City/District |State |Pin code |Sex (in case of individual) (Tick) ( |

| | | | |

| | |() - | |

| | | | |

| | |

| |Whether original or Revised return? (Tick) ( | |Original | |Revised |

| | |

| |If revised, then enter Receipt No and Date of filing original return (DD/MM/YYYY) | | |

| | |

| |Residential Status (Tick) ( | |Resident | |Non-Resident | |Resident but Not Ordinarily Resident |

| | |

| |Whether this return is being filed by a representative assessee ? (Tick) ( | |Yes | |No |

| |If yes, please furnish following information – |

| |(a) |Name of the representative | |

| |(b) |Address of the representative | |

| |(c) |Permanent Account Number (PAN) of the representative | |

| | | | |

|AUDIT |Are you liable to maintain accounts as per section 44AA? (Tick) ( | |Yes | |No |

|INFORM| | | | | |

|ATION | | | | | |

| | |

| |Are you liable for audit under section 44AB? (Tick) ( | |Yes | |No |If yes, furnish following information- |

| | |

| |(a) |Name of the auditor signing the tax audit report | |

| |(b) |Membership no. of the auditor | |

| |(c) |Name of the auditor (proprietorship /firm) | |

| |(d) |Permanent Account Number (PAN) of the proprietorship /firm | |

| |(e) |Date of audit report. | |

| | | | |

For Office Use Only

Receipt No

Date

Seal and Signature of receiving official

|NATURE |Nature of business or profession, if more than one business or profession indicate the three main activities/ products |

|OF | |

|BUSINES| |

|S | |

| |S. No. |Code [Please see |Trade name of the proprietorship, if any |Description |

| | |instruction No.9(ii)] | | |

| |(i) | | | |

| |(ii) | | | |

| |(iii) | | | |

B/S

|Part A - BS |BALANCE SHEET AS ON 31st DAY OF MARCH -2009 OF THE PROPRIETORY BUSINESS |

| |(fill items 1 to 5 in a case where regular books of accounts are maintained, otherwise fill item 6) |

| |1 |Proprietor’s fund | |

| | |a |Proprietor’s capital |a | |

| | |b |Reserves and Surplus | |

| | | |i |Revaluation Reserve |bi | | |

| | | |ii |Capital Reserve |bii | | |

| | | |iii |Statutory Reserve |biii | | |

| | | |iv |Any other Reserve |biv | | |

| | | |v |Total (bi+bii+biii+biv) |bv | |

| | |c |Total proprietor’s fund (a+bv) |1c | |

| |2 |Loan funds | |

| | |a |Secured loans | |

| | | |i |Foreign Currency Loans |ai | | |

| | | |ii |Rupee Loans | |

| | | | |A |From |iiA |

| | | | | |Banks | |

| | |b |Unsecured loans (including deposits) | |

| | | | |i |From Banks |bi | |

| | |c |Total Loan Funds (aiii+biii) |2c | |

| |3 |Deferred tax liability |3 | |

| |4 |Sources of funds (1c+2c+3) |4 | |

| |1 |Fixed assets | |

| | |a |Gross: Block |1a | | |

| | |b |Depreciation |1b | | |

| | |c |Net Block (a – b) |1c | | |

| | |d |Capital work-in-progress |1d | | |

| | |e |Total (1c + 1d) |1e | |

| |2 |Investments | |

| | |a |Long-term investments | |

| | | |i |Government and other Securities - Quoted |ai | | |

| | | |ii |Government and other Securities – Unquoted |aii | | |

| | | |iii |Total (ai + aii) |aiii | |

| | |b |Short-term investments | | |

| | | |i |Equity Shares, including share application money |bi | | |

| | | |ii |Preference Shares |bii | | |

| | | |iii |Debentures |biii | | |

| | | |iv |Total (bi + bii + biii) |biv | |

| | |c |Total investments (aiii + biv) |2c | |

| |3 |Current assets, loans and advances | |

| | |a |Current assets | |

| | | |i |Inventories | |

| | | | |A |Stores/ consumables including packing Materials |iA | |

| | | |ii |Sundry Debtors |aii | |

| | | |iii |Cash and Bank Balances | |

| | | | |A |Cash-in-hand |iiiA | |

| | | |iv |Other Current Assets |aiv | |

| | | | v |Total current assets (iE + aii + iiiC + aiv) |av | |

| | |b |Loans and advances | |

| | | |i |Advances recoverable in cash or in kind or for value |bi | | |

| | | | |to be received | | | |

| | | |ii |Deposits, loans and advances to corporates and others|bii | | |

| | | |iii |Balance with Revenue Authorities |biii | | |

| | | |iv |Total (bi + bii + biii) |biv | |

| | |c |Total of current assets, loans and advances (av + biv) |3c | |

| | |d |Current liabilities and provisions | |

| | | |i |Current liabilities | |

| | | | |A |Sundry Creditors |

| | | | |A |Provision for Income Tax |iiA | |

| | | |iii |Total (iE + iiE) |diii | |

| | |e |Net current assets (3c – diii) |3e | |

| |4 |a |Miscellaneous expenditure not written off or adjusted |4a | | | |

| | |b |Deferred tax asset |4b | | | |

| | |c |Profit and loss account/ Accumulated balance |4c | | | |

| | |d |Total (4a + 4b + 4c) |4d | |

| |5 |Total, application of funds (1e + 2c + 3e +4d) |5 | |

| |6 |In a case where regular books of account of business or profession are not maintained- | | |

| | |(furnish the following information as on 31st day of March, 2009, in respect of business or profession) | | |

| |a |Amount of total sundry debtors |6a | |

| |b |Amount of total sundry creditors |6b | |

| |c |Amount of total stock-in-trade |6c | |

| |d |Amount of the cash balance |6d | |

P & L A/c

|Part A-P& L |Profit and Loss Account for the previous year 2008-09 of the proprietary business |

| |(fill items 1 to 50 in a case where regular books of accounts are maintained, otherwise fill item 51) |

| |1 |Sales/Gross receipts of business or profession |1 | |

| | |(Net of returns and refunds and duty or tax, if any) | | |

| |2 |Duties, taxes and cess, received or receivable, in respect of goods and services sold or supplied | |

| | |a |Union Excise duties |2a | | |

| | |b |Service tax |2b | | |

| | |c |VAT/Sales tax |2c | | |

| | |d |Any other duty, tax and cess |2d | | |

| | |e |Total of duties, taxes and cess, received or receivable (2a+2b+2c+2d) |2e | |

| |3 |Other income | |

| | |a |Rent |3a | | |

| | |b |Commission |3b | | |

| | |c |Dividend |3c | | |

| | |d |Interest |3d | | |

| | |e |Profit on sale of fixed assets |3e | | |

| | |f |Profit on sale of investment being securities |3f | | |

| | | |chargeable to Securities Transaction Tax (STT) | | | |

| | |g |Profit on sale of other investment |3g | | |

| | |h |Profit on account of currency fluctuation |3h | | |

| | |I |Agriculture income |3i | | |

| | |j |Any other income |3j | | |

| | |k |Total of other income (3a to 3j). |3k | |

| |4 |Closing stock |4 | |

| |5 |Totals of credits to profit and loss account (1+2e+3k+4) |5 | |

| |6 |Opening Stock |6 | |

| |7 |Purchases (net of refunds and duty or tax, if any) |7 | |

| |8 |Duties and taxes, paid or payable, in respect of goods and services purchased | |

| | |a |Custom duty |8a | | |

| | |b |Counter vailing duty |8b | | |

| | |c |Special additional duty |8c | | |

| | |d |Union excise duty |8d | | |

| | |e |Service tax |8e | | |

| | |f |VAT/Sales tax |8f | | |

| | |g |Any other tax, paid or payable |8g | | |

| | |h |Total (8a+8b+8c+8d+8e+8f+8g) |8h | |

| |9 |Freight |9 | |

| |10 |Consumption of stores and spare parts |10 | |

| |11 |Power and fuel |11 | |

| |12 |Rents |12 | |

| |13 |Repairs to building |13 | |

| |14 |Repairs to machinery |14 | |

| |15 |Compensation to employees | |

| | |a |Salaries and wages |15a | | |

| | |b |Bonus |15b | | |

| | |c |Reimbursement of medical expenses |15c | | |

| | |d |Leave encashment |15d | | |

| | |e |Leave travel benefits |15e | | |

| | |f |Contribution to approved superannuation fund |15f | | |

| | |g |Contribution to recognised provident fund |15g | | |

| | |h |Contribution to recognised gratuity fund |15h | | |

| | |i |Contribution to any other fund |15i | | |

| | |j |Any other benefit to employees in respect of which an |15j | | |

| | | |expenditure has been incurred | | | |

| | |k |Total compensation to employees |15k | |

| | | |(15a+15b+15c+15d+15e+15f+15g+15h+15i+15j) | | |

| |16 |Insurance | |

| | |a |Medical Insurance |16a | | |

| | |b |Life Insurance |16b | | |

| | |c |Keyman’s Insurance |16c | | |

| | |d |Other Insurance |16d | | |

| | |e |Total expenditure on insurance (16a+16b+16c+16d) |16e | |

| |17 |Workmen and staff welfare expenses |17 | |

| |18 |Entertainment |18 | |

| |19 |Hospitality |19 | |

| |20 |Conference |20 | |

| |21 |Sales promotion including publicity (other than advertisement) |21 | |

| |22 |Advertisement |22 | |

| |23 |Commission |23 | |

| |24 |Hotel, boarding and Lodging |24 | |

| |25 |Traveling expenses including foreign traveling |25 | |

| |26 |Conveyance expenses |26 | |

| |27 |Telephone expenses |27 | |

| |28 |Guest House expenses |28 | |

| |29 |Club expenses |29 | |

| |30 |Festival celebration expenses |30 | |

| |31 |Scholarship |31 | |

| |32 |Gift |32 | |

| |33 |Donation |33 | |

| |34 |Rates and taxes, paid or payable to Government or any local body | |

| | |(excluding taxes on income) | |

| | |a |Union excise duty |34a | | |

| | |b |Service tax |34b | | |

| | |c |VAT/ Sales tax |34c | | |

| | |d |Cess |34d | | |

| | |e |Any other rate, tax, duty or cess incl STT Paid |34e | | |

| | |f |Total rates and taxes paid or payable (34a+34b+34c+34d+34e) |34f | |

| |35 |Audit fee |35 | |

| |36 |Other expenses |36 | |

| |37 |Bad debts |37 | |

| |38 |Provision for bad and doubtful debts |38 | |

| |39 |Other provisions |39 | |

| |40 |Profit before interest, depreciation and taxes |40 | |

| | |[5 – (6 + 7 + 8h + 9 to 14 + 15k + 16e + 17 to 33 + 34f + 35 to 39)] | | |

| |41 |Interest |41 | |

| |42 |Depreciation |42 | |

| |43 |Profit before taxes (40-41-42) |43 | |

| |44 |Provision for current tax |44 | |

| |45 |Provision for Deferred Tax |45 | |

| |46 |Profit after tax (43 – 44 – 45) |46 | |

| |47 |Balance brought forward from previous year |47 | |

| |48 |Amount available for appropriation (46+47) |48 | |

| |49 |Transferred to reserves and surplus |49 | |

| |50 |Balance carried to balance sheet in proprietor’s account(48- 49) |50 | |

| |51 |In a case where regular books of account of business or profession are not maintained, furnish the | | |

| | |following information for previous year 2008-09 in respect of business or profession | | |

| | |a |Gross receipts |51a | |

| | |b |Gross profit |51b | |

| | |c |Expenses |51c | |

| | |d |Net profit |51d | |

Tax Audit

|Part A- OI |Other Information (optional in a case not liable for audit under section 44AB) |

| | |

| |1 |Method of accounting employed in the previous year (Tick) ( | |Mercantile | |Cash |

| | |

| |2 |Is there any change in method of accounting (Tick) ( | | Yes | |No |

| | |

| |3 |Effect on the profit because of deviation, if any, in the method of accounting employed in the previous |3 | |

| | |year from accounting standards prescribed under section 145A | | |

| |4 |Method of valuation of closing stock employed in the previous year |

| | |a |Raw Material (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3) | |

| | |b |Finished goods (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write3) | |

| | | |

| | |c |Is there any change in stock valuation method (Tick) ( | |Yes | |No |

| | | |

| | |d |Effect on the profit or loss because of deviation, if any, from the method of valuation prescribed|4d | |

| | | |under section 145A | | |

| |5 |Amounts not credited to the profit and loss account, being - | |

| | |a |The items falling within the scope of section 28 |5a | | |

| | |b |The proforma credits, drawbacks, refund of duty of customs or |5b | | |

| | | |excise or service tax, or refund of sales tax or value added tax, | | | |

| | | |where such credits, drawbacks or refunds are admitted as due by the| | | |

| | | |authorities concerned | | | |

| | |c |Escalation claims accepted during the previous year |5c | | |

| | |d |Any other item of income |5d | | |

| | |e |Capital receipt, if any |5e | | |

| | |f |Total of amounts not credited to profit and loss account (5a+5b+5c+5d+5e) |5f | |

| | 6 Amounts debited to the profit and loss account, to the extent disallowable under section 36: - | |

| | |a |Premium paid for insurance against risk of damage or destruction of|6a | | |

| | | |stocks or store | | | |

| | |b |Premium paid for insurance on the health of employees |6b | | |

| | |c |Any sum paid to an employee as bonus or commission for services |6c | | |

| | | |rendered, where such sum was otherwise payable to him as profits or| | | |

| | | |dividend. | | | |

| | |d |Any amount of interest paid in respect of borrowed capital |6d | | |

| | |e |Amount of discount on a zero-coupon bond |6e | | |

| | |f |Amount of contributions to a recognized provident fund |6f | | |

| | |g |Amount of contributions to an approved superannuation fund |6g | | |

| | |h |Amount of contributions to an approved gratuity fund |6h | | |

| | |i |Amount of contributions to any other fund |6i | | |

| | |j |Amount of bad and doubtful debts |6j | | |

| | |k |Provision for bad and doubtful debts |6k | | |

| | |l |Amount transferred to any special reserve |6l | | |

| | |m |Expenditure for the purposes of promoting family planning amongst |6m | | |

| | | |employees | | | |

| | |n |Any sum received from employees as contribution to any provident |6n | | |

| | | |fund or superannuation fund or any fund set up under ESI Act or any| | | |

| | | |other fund for the welfare of employees to the extent credited to | | | |

| | | |the employees account on or before the due date | | | |

| | |o |Any other disallowance |6o | | |

| | |p |Total amount disallowable under section 36 (total of 6a to 6o) |6p | |

| |7 |Amounts debited to the profit and loss account, to the extent disallowable under | |

| | |Section 37 | |

| | |a |Expenditure of personal nature; |7a | | |

| | |b |Expenditure on advertisement in any souvenir, brochure, tract, |7b | | |

| | | |pamphlet or the like, published by a political party; | | | |

| | |c |Expenditure by way of penalty or fine for violation of any law for |7c | | |

| | | |the time being in force; | | | |

| | |d |Any other penalty or fine; |7d | | |

| | |e |Expenditure incurred for any purpose which is an offence or which |7e | | |

| | | |is prohibited by law; | | | |

| | |f |Amount of any liability of a contingent nature |7f | | |

| | |g |Amount of expenditure in relation to income which does not form |7g | | |

| | | |part of total income | | | |

| | |h |Any other amount not allowable under section 37 |7h | | |

| | |i |Total amount disallowable under section 37(total of 7a to 7h) |7i | |

| |8 |A |Amounts debited to the profit and loss account, to the extent disallowable under section 40 | |

| | |a |Amount disallowable under section 40 (a) (i), 40 (a)(ia) and |Aa | | |

| | | |40(a)(iii) on account of non-compliance with the provisions of | | | |

| | | |Chapter XVII-B | | | |

| | |b |Amount paid as fringe benefit tax |Ab | | |

| | |c |Amount of tax or rate levied or assessed on the basis of profits |Ac | | |

| | |d |Amount paid as wealth tax |Ad | | |

| | |e |Amount of interest, salary, bonus, commission or remuneration paid |Ae | | |

| | | |to any partner or member | | | |

| | |f |Any other disallowance |Af | | |

| | |g |Total amount disallowable under section 40(total of Aa to Af) |8 Ag | |

| | |B |Any amount disallowed under section 40 in any preceding previous year but allowable during the |8B | |

| | | |previous year | | |

| |9 Amounts debited to the profit and loss account, to the extent disallowable under section 40A | |

| | |a |Amounts paid to persons specified in section 40A(2)(b) |9a | | |

| | |b |Amount in excess of twenty thousand rupees, paid to a person in a |9b | | |

| | | |day otherwise than by account payee cheque or account payee bank | | | |

| | | |draft under section 40A(3) – 100% disallowable | | | |

| | |c |Provision for payment of gratuity |9c | | |

| | |d |any sum paid by the assessee as an employer for setting up or as |9d | | |

| | | |contribution to any fund, trust, company, AOP, or BOI or society or| | | |

| | | |any other institution; | | | |

| | |e |Any other disallowance |9e | | |

| | |f |Total amount disallowable under section 40A (total of 9a to 9e) |9f | |

| |10 Any amount disallowed under section 43B in any preceding previous year but allowable during the previous | |

| |year | |

| | |a |Any sum in the nature of tax, duty, cess or fee under any law |10a | | |

| | |b |Any sum payable by way of contribution to any provident fund or |10b | | |

| | | |superannuation fund or gratuity fund or any other fund for the | | | |

| | | |welfare of employees | | | |

| | |c |Any sum payable to an employee as bonus or commission for services |10c | | |

| | | |rendered | | | |

| | |d |Any sum payable as interest on any loan or borrowing from any |10d | | |

| | | |public financial institution or a State financial corporation or a | | | |

| | | |State Industrial investment corporation | | | |

| | |e |Any sum payable as interest on any loan or borrowing from any |10e | | |

| | | |scheduled bank | | | |

| | |f |Any sum payable towards leave encashment |10f | | |

| | |g |Total amount allowable under section 43B (total of 10a to 10f) |10g | |

| |11 Any amount debited to profit and loss account of the previous year but disallowable under section 43B: - | |

| | |a |Any sum in the nature of tax, duty, cess or fee under any law |11a | | |

| | |b |Any sum payable by way of contribution to any provident fund or |11b | | |

| | | |superannuation fund or gratuity fund or any other fund for the | | | |

| | | |welfare of employees | | | |

| | |c |Any sum payable to an employee as bonus or commission for services |11c | | |

| | | |rendered | | | |

| | |d |Any sum payable as interest on any loan or borrowing from any |11d | | |

| | | |public financial institution or a State financial corporation or a | | | |

| | | |State Industrial investment corporation | | | |

| | |e |Any sum payable as interest on any loan or borrowing from any |11e | | |

| | | |scheduled bank | | | |

| | |f |Any sum payable towards leave encashment |11f | | |

| | |g |Total amount disallowable under Section 43B(total of 11a to 11f) |11g | |

| |12 |Amount of credit outstanding in the accounts in respect of | |

| | |a |Union Excise Duty |12a | | |

| | |b |Service tax |12b | | |

| | |c |VAT/sales tax |12c | | |

| | |d |Any other tax |12d | | |

| | |e |Total amount outstanding (total of 12a to 12d) |12e | |

| |13 |Amounts deemed to be profits and gains under section 33AB or 33ABA or 33AC |13 | |

| |14 |Any amount of profit chargeable to tax under section 41 |14 | |

| |15 |Amount of income or expenditure of prior period credited or debited to the profit and loss account (net) |15 | |

| |

|Part A – QD |Quantitative details (optional in a case not liable for audit under section 44AB) |

| |(a) |In the case of a trading concern | | |

| | |1 |Opening stock |1 | |

| | |2 |Purchase during the previous year |2 | |

| | |3 |Sales during the previous year |3 | |

| | |4 |Closing stock |4 | |

| | |5 |Shortage/ excess, if any |5 | |

| |(b) |In the case of a manufacturing concern | |

| | |6 |Raw materials | | |

| | | |a |Opening stock |6a | |

| | | |b |Purchases during the previous year |6b | |

| | | |c |Consumption during the previous year |6c | |

| | | |d |Sales during the previous year |6d | |

| | | |e |Closing stock |6e | |

| | | |f |Yield finished products |6f | |

| | | |g |Percentage of yield |6g | |

| | | |h |Shortage/ excess, if any |6h | |

| | |7 |Finished products/ By-products | | |

| | | |a |Opening stock |7a | |

| | | |b |Purchase during the previous year |7b | |

| | | |c |Quantity manufactured during the previous year |7c | |

| | | |d |Sales during the previous year |7d | |

| | | |e |Closing stock |7e | |

| | | |f |Shortage/ excess, if any |7f | |

Total Income & Tax

|Part B - TI |Computation of total income |

| |1 |Salaries (6 of Schedule S) |1 | |

| |2 |Income from house property (4c of Schedule-HP) (enter nil if loss) |2 | |

| |3 |Profits and gains from business or profession | |

| | |i |Profit and gains from business other than speculative |3i | | |

| | | |business (A37 of Schedule-BP) | | | |

| | |ii |Profit and gains from speculative business (B41 of |3ii | | |

| | | |Schedule-BP) (enter nil if loss) | | | |

| | |iii|Total (3i + 3ii) (enter nil if 3iii is a loss) |3iii | |

| |4 |Capital gains | |

| | |a |Short term | |

| | | |i |Short-term (under section 111A) (A7 of Schedule -CG) (enter |4ai | | |

| | | | |nil if loss) | | | |

| | | |ii |Short-term (others) (A8 of Schedule-CG) |4aii| | |

| | | |iii |Total short-term (4ai + 4aii) |4aii| | |

| | | | | |i | | |

| | |b |Long-term (B6 of Schedule-CG) (enter nil if loss) |4b | | |

| | |c |Total capital gains (4aiii + 4b) (enter nil if 4c is a loss) |4c | |

| |5 |Income from other sources | |

| | |a |From sources other than from owning race horses (3 of Schedule OS) |5a | | |

| | | |(enter nil if loss) | | | |

| | |b |From owning race horses (4c of Schedule OS) (enter nil if loss) |5b | | |

| | |c |Total (5a + 5b) |5c | |

| |6 |Total (1 + 2 + 3iii +4c +5c) |6 | |

| |7 |Losses of current year to be set off against 6 (total of 2vii, 3vii and 4vii of Schedule CYLA) |7 | |

| |8 |Balance after set off current year losses (6 – 7) |8 | |

| |9 |Brought forward losses to be set off against 6 (total of 2vii, 3vii and 4vii of Schedule BFLA) |9 | |

| |10 |Gross Total income (8 – 9) (also 5viii of Schedule BFLA) |10 | |

| |11 |Deductions under Chapter VI-A (s of Schedule VIA) |11 | |

| |12 |Total income (10 – 11) |12 | |

| |13 |Net agricultural income/ any other income for rate purpose (4 of Schedule EI) |13 | |

| |14 |‘Aggregate income’ (12 + 13) |14 | |

| |15 |Losses of current year to be carried forward (total of xi of CFL) |15 | |

|Part B - TTI|Computation of tax liability on total income |

| |1 |Tax payable on total income | |

| | |a |Tax at normal rates |1a | | |

| | |b |Tax at special rates (11 of Schedule-SI) |1b | | |

| |2 |Tax Payable on Total Income (1a + 1b) |2 | |

| |3 |Surcharge on 2 |3 | |

| |4 |Education Cess , including secondary and higher education cess on (2+3) |4 | |

| |5 |Gross tax liability (2+3+4) |5 | |

| |6 |Tax relief | |

| | |a |Section 89 |6a | | |

| | |b |Section 90 |6b | | |

| | |c |Section 91 |6c | | |

| | |d |Total (6a + 6b+6c) |6d | |

| |7 |Net tax liability (5 – 6d) |7 | |

| |8 |Interest payable | |

| | |a |For default in furnishing the return (section 234A) |8a | | |

| | |b |For default in payment of advance tax (section 234B) |8b | | |

| | |c |For deferment of advance tax (section 234C) | 8c | | |

| | |d |Total Interest Payable (8a+8b+8c) |8d | |

| |9 |Aggregate liability (7 + 8d) |9 | |

| |10 |Taxes Paid | |

| | |a |Advance Tax (from Schedule-IT) |10a | | |

| | |b |TDS (Total of column 7 of Schedule-TDS1 and column 7 of Schedule |10b | | |

| | | |–TDS 2 ) | | | |

| | |c |TCS (column 7 of Schedule-TCS) |10c | | |

| | |d |Self Assessment Tax (from Schedule-IT) |10d | | |

| | |e |Total Taxes Paid (10a+10b+10c + 10d) |10e | |

| |11 |Amount payable (Enter if 9 is greater than 10e, else enter 0) |11 | |

| |12 |Refund (If 10e is greater than 9, also give bank account details below) |12 | |

| |13 |Enter your bank account number (mandatory in case of refund) | |

| |14 |Do you want your refund by | |Cheque, or | |deposited directly into your bank account? (tick as applicable ( ) |

| |15 |Give additional details of your bank account | |

| |MICR Code | |Type of Account (tick as applicable( ) | |Savings | |Current |

Verification

| |

|VERIFICATION |

|I, son / daughter of ,holding permanent account number solemnly declare that to the best of my knowledge and belief, |

|the information given in the return and the schedules thereto is correct and complete and that the amount of total income and other particulars shown |

|therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in respect of income chargeable to income-tax for the |

|previous year relevant to the assessment year 2009-10. |

|Place | |Date | |Sign here ( |

|17 |If the return has been prepared by a Tax Return Preparer (TRP) give further details below: |

|Identification No. of TRP |Name of TRP |Counter Signature of TRP |

| | | |

| | | |

|If TRP is entitled for any reimbursement from the Government, amount thereof…………… |18 | |

Salary

House Property

|Schedule S |Details of Income from Salary |

| |Name of Employer |PAN of Employer (optional) |

| | | |

| |Address of employer |Town/City |State |Pin code |

| | | | | |

| |1 |Salary (Excluding all allowances, perquisites & profit in lieu of salary).. |1 | |

| |2 |Allowances exempt under section 10 |2 | | |

| |3 |Allowances not exempt |3 | |

| |4 |Value of perquisites |4 | |

| |5 |Profits in lieu of salary |5 | |

| |6 |Income chargeable under the Head ‘Salaries’ (1+3+4+5) |6 | |

| | | | | |

|Schedule HP |Details of Income from House Property (Please refer to instructions) |

| |

| | | Address of property |Town/ City |State |PIN Code |

| | | | | | |

| | | |Name of Tenant |PAN of Tenant(optional) |

| | |(Tick) _ if let out | | | |

| | |a | Annual letable value/ rent received or receivable (higher if let out for whole of the year, lower if |1a | |

| | | |let out for part of the year) | | |

| | |b |The amount of rent which cannot be realized |1b | | |

| | |c |Tax paid to local authorities |1c | | |

| | |d |Total (1b + 1c) |1d | | |

| | |e |Balance (1a – 1d) |1e | |

| | |f |30% of 1e |1f | | |

| | |g |Interest payable on borrowed capital |1g | | |

| | |h |Total (1f + 1g) |1h | |

| | |i |Income from house property (1e – 1h) |1i | |

| | | | | | |

| |4 | |Income under the head “Income from house property” | |

| | |a |Rent of earlier years realized under section 25A/AA |4a | |

| | |b |Arrears of rent received during the year under section 25B after deducting 30% |4b | |

| | |c |Total (from all properties) |4c | |

| |NOTE |Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head |

Business

|Schedule BP |Computation of income from business or profession |

| |A |From business or profession other than speculative business | |

| | |1 |Profit before tax as per profit and loss account (item 43 or item 51d of Part A-P&L |1 | |

| | |2 |Net profit or loss from speculative business included in 1 |2 | | |

| | |3 |Income/ receipts credited to profit and loss account |3 | | |

| | | |considered under other heads of income | | | |

| | |4 |Profit or loss included in 1, which is referred to in |4 | | |

| | | |Section 44AD/44AE/44AF/44B/44BB/44BBA /44BBB/ 44D/44DA | | | |

| | | |Chapter-XII-G/ First Schedule of Income tax Act | | | |

| | |5 |Income credited to Profit and Loss account (included in 1) which is exempt |

| | | |a |Share |5a |

| | | | |of | |

| | | | |income| |

| | | | |from | |

| | | | |firm(s| |

| | | | |) | |

| | |7 |Expenses debited to profit and loss account considered under |7 | | |

| | | |other heads of income | | | |

| | |8 |Expenses debited to profit and loss account which relate to |8 | | |

| | | |exempt income | | | |

| | |9 |Total (7 + 8) |9 | | |

| | |10 |Adjusted profit or loss (6+9) |10 | |

| | |11 |Depreciation debited to profit and loss account included in 9 |11 | |

| | |12 |Depreciation allowable under Income-tax Act | |

| | | |i |Depreciation allowable under section 32(1)(ii) |12i | |

| | | | |(Column 6 of Schedule-DEP) | | |

| | |13 |Profit or loss after adjustment for depreciation (10 +11 - 12iii) |13 | |

| | |14 |Amounts debited to the profit and loss account, to the extent |14 | | |

| | | |disallowable under section 36 (6p of Part-OI) | | | |

| | |15 |Amounts debited to the profit and loss account, to the extent |15 | | |

| | | |disallowable under section 37 (7i of Part-OI) | | | |

| | |16 |Amounts debited to the profit and loss account, to the extent |16 | | |

| | | |disallowable under section 40 (8Ag of Part-OI) | | | |

| | |17 |Amounts debited to the profit and loss account, to the extent |17 | | |

| | | |disallowable under section 40A (9f of Part-OI) | | | |

| | |18 |Any amount debited to profit and loss account of the previous |18 | | |

| | | |year but disallowable under section 43B (11g of Part- OI) | | | |

| | |19 |Interest disallowable under section 23 of the Micro, Small and|19 | | |

| | | |Medium Enterprises Development Act, 2006 | | | |

| | |20 |Deemed income under section 41 |20 | | |

| | |21 |Deemed income under section 33AB/33ABA/35ABB/ |21 | | |

| | | |72A/80HHD/80-IA | | | |

| | |22 |Any other item or items of addition under section 28 |22 | | |

| | | |to 44DA | | | |

| | |23 |Any other income (including income from salary, commission, | | | |

| | | |bonus and interest from firms in which an individual/HUF/Prop.|23 | | |

| | | |Concern is a partner) not included in profit and loss | | | |

| | |24 |Total (14 + 15 + 16 + 17 + 18 + 19 + 20 + 21+22+23) |24 | |

| | |25 |Deduction allowable under section 32(1)(iii) |25 | | |

| | |26 |Amount of deduction under section 35 in excess of the amount |26 | | |

| | | |debited to profit and loss account (item vii (4) of schedule | | | |

| | | |ESR) | | | |

| | |27 |Any amount disallowed under section 40 in any preceding | | | |

| | | |previous year but allowable during the previous year (8B of |27 | | |

| | | |part –OI) | | | |

| | |28 |Any amount disallowed under section 43B in any preceding | | | |

| | | |previous year but allowable during the previous year (10g of |28 | | |

| | | |part –OI) | | | |

| | |29 |Deduction under section 35AC | | | |

| | | |a |Amount,|29a | |

| | | | |if any,| | |

| | | | |debited| | |

| | | | |to | | |

| | | | |profit | | |

| | | | |and | | |

| | | | |loss | | |

| | | | |account| | |

| | |31 |Total (25 + 26+27+28+29c+30) |31 | |

| | |32 |Income (13 + 24 -31) |32 | |

| | |33 |Profits and gains of business or profession deemed to be under | |

| | | |i |Section 44AD |33i | |

| | |34 |Profit or loss before deduction under section 10A/10AA/10B/10BA (32+ 33xi) |34 | |

| | |35 |Deductions under section- | |

| | | |i |10A (6 of Schedule-10A) |35i | |

| | |36 |Net profit or loss from business or profession other than speculative business (34 – 35v) |36 | |

| | |37 |Net Profit or loss from business or profession (same as above in 36 except in case of special |A37 | |

| | | |business, after applying rule 7A, 7B, 7C) | | |

| |B |Computation of income from speculative business | |

| | |38 |Net profit or loss from speculative business as per profit or loss account |38 | |

| | |39 |Additions in accordance with section 28 to 44DA |39 | |

| | |40 |Deductions in accordance with section 28 to 44DA |40 | |

| | |41 |Profit or loss from speculative business (38+39-40) |B41 | |

| |C |Income chargeable under the head ‘Profits and gains’ (A37+B41) |C | |

|NOTE |Please include the income of the specified persons referred to in schedule SPI while computing the income under this head |

Depreciation

|Schedule DPM |Depreciation on Plant and Machinery |

| |1 |Block of assets |Plant and machinery |

| |2 |

| |1 |Block of assets |Building |Furniture and |Intangible |Ships |

| | | | |fittings |assets | |

| |2 |

| |1 |Plant and machinery | |

| | |a |Block entitled for depreciation @ 15 per cent |1a | | |

| | | |(Schedule DPM - 14 i) | | | |

| | |b |Block entitled for depreciation @ 30 per cent |1b | | |

| | | |(Schedule DPM - 14 ii) | | | |

| | |c |Block entitled for depreciation @ 40 per cent |1c | | |

| | | |(Schedule DPM - 14 iii) | | | |

| | |d |Block entitled for depreciation @ 50 per cent |1d | | |

| | | |(Schedule DPM - 14 iv) | | | |

| | |e |Block entitled for depreciation @ 60 per cent |1e | | |

| | | |(Schedule DPM - 14 v) | | | |

| | |f |Block entitled for depreciation @ 80 per cent |1f | | |

| | | |(Schedule DPM – 14 vi) | | | |

| | |g |Block entitled for depreciation @ 100 per cent |1g | | |

| | | |(Schedule DPM - 14 vii) | | | |

| | |h |Total depreciation on plant and machinery (1a + 1b + 1c + 1d+ 1e + 1f + 1g) |1h | |

| |2 |Building | |

| | |a |Block entitled for depreciation @ 5 per cent |2a | | |

| | | |(Schedule DOA- 14i) | | | |

| | |b |Block entitled for depreciation @ 10 per cent (Schedule DOA- 14ii)|2b | | |

| | |c |Block entitled for depreciation @ 100 per cent |2c | | |

| | | |(Schedule DOA- 14iii) | | | |

| | |d |Total depreciation on building (total of 2a + 2b + 2c) |2d | |

| |3 |Furniture and fittings (Schedule DOA- 14 iv) |3 | |

| |4 |Intangible assets (Schedule DOA- 14 v) |4 | |

| |5 |Ships (Schedule DOA- 14 vi) |5 | |

| |6 |Total depreciation (1h+2d+3+4+5) |6 | |

|Schedule DCG |Deemed Capital Gains on sale of depreciable assets |

| |1 |Plant and machinery | |

| | |a |Block entitled for depreciation @ 15 per cent |1a | | |

| | | |(Schedule DPM - 16i) | | | |

| | |b |Block entitled for depreciation @ 30 per cent (Schedule DPM – |1b | | |

| | | |16ii) | | | |

| | |c |Block entitled for depreciation @ 40 per cent (Schedule DPM - |1c | | |

| | | |16iii) | | | |

| | |d |Block entitled for depreciation @ 50 per cent |1d | | |

| | | |(Schedule DPM - 16iv) | | | |

| | |e |Block entitled for depreciation @ 60 per cent |1e | | |

| | | |(Schedule DPM – 16v) | | | |

| | |f |Block entitled for depreciation @ 80 per cent (Schedule DPM – |1f | | |

| | | |16vi) | | | |

| | |g |Block entitled for depreciation @ 100 per cent |1g | | |

| | | |(Schedule DPM – 16vii) | | | |

| | |h |Total (1a +1b + 1c + 1d + 1e + 1f + 1g) |1h | |

| |2 |Building | |

| | |a |Block entitled for depreciation @ 5 per cent |2a | | |

| | | |(Schedule DOA- 16i) | | | |

| | |b |Block entitled for depreciation @ 10 per cent (Schedule DOA- 16ii)|2b | | |

| | |c |Block entitled for depreciation @ 100 per cent |2c | | |

| | | |(Schedule DOA- 16iii) | | | |

| | |d |Total (2a + 2b + 2c) |2d | |

| |3 |Furniture and fittings (Schedule DOA- 16iv) |3 | |

| |4 |Intangible assets (Schedule DOA- 16v) |4 | |

| |5 |Ships (Schedule DOA- 16vi) |5 | |

| |6 |Total (1h+2d+3+4+5) |6 | |

|Schedule ESR |Deduction under section 35 |

|Sl.No. |Expenditure of the nature referred |Amount, if any, debited to profit |Amount of deduction allowable |Amount of deduction in excess of |

| |to in section |and loss account | |the amount debited to profit and |

| | | | |loss account |

| |(1) | |(3) |(4 )=(3) – (2) |

| | |(2) | | |

|i |35 (1)(i) | | | |

|ii |35(1)(ii) | | | |

|Iii |35(1)(iii) | | | |

|iv |35(1)(iv) | | | |

|V |35(2AA) | | | |

|Vi |35(2AB) | | | |

|vii |total | | | |

Capital Gains

|Schedule CG |Capital Gains |

| |A |Short-term capital gain | |

| | |1 |From slump sale | |

| | | |a |Full value of consideration |1a | | |

| | | |b |Net worth of the under taking or division |1b | | |

| | | |c |Short term capital gains from slump |1c | | |

| | | | |sale | | | |

| | | |d |Deduction under sections 54B/54D |1d | | |

| | | |e |Net short term capital gains from slum sale (1c – 1d) |1e | |

| | |2 |From assets in case of non-resident to which first proviso to section 48 applicable |2 | |

| | |3 |From assets in the case of others | |

| | | |a |Full value of consideration |3a | | |

| | | |b |Deductions under section 48 | |

| | | | |i |Cost of|bi | |

| | | | | |acquisi| | |

| | | | | |tion | | |

| | | |d |Loss, if any, to be ignored under section 94(7) or 94(8) (enter |3d | | |

| | | | |positive values only) | | | |

| | | |e |Deduction under section |3e | | |

| | | | |54B/54D | | | |

| | | |f |Short-term capital gain (3c – 3d – 3e) |3f | |

| | |4 |Deemed short capital gain on depreciable assets (6 of Schedule-DCG) |4 | |

| | |5 |Amount deemed to be short term capital gains under sections |5 | |

| | | |54B/54D/54EC/54ED/54G/ 54GA | | |

| | |6 |Total short term capital gain (1e + 2 +3f +4 +5) |6 | |

| | |7 |Short term capital gain under section 111A included in 6 |7 | |

| | |8 |Short term capital gain other than referred to in section 111A (6 – 7) |A8 | |

| |B |Long term capital gain | |

| | |1 |From slump sale | |

| | | |a |Full value of consideration |1a | | |

| | | |b |Net worth of the under taking or Division |1b | | |

| | | |c |Long term capital gains from slump Sale |1c | | |

| | | |d |Deduction under sections |1d | | |

| | | | |54/54B/54D/54EC/54F/54G/ 54GA | | | |

| | | |e |Net long term capital gain from slump sale (1c – 1d) |1e | |

| | |2 |Asset in case of non-resident to which first proviso to section 48 applicable |2 | |

| | |3 |Asset in the case of others where proviso under section 112(1) not exercised | |

| | | |a |Full value of consideration |3a | | |

| | | |b |Deductions under section 48 | |

| | | | |i |Cost of|bi | |

| | | | | |acquisi| | |

| | | | | |tion | | |

| | | | | |after | | |

| | | | | |indexat| | |

| | | | | |ion | | |

| | | |d |Deduction under sections |3d | | |

| | | | |54/54B/54D/54EC/54F/54G/ 54GA | | | |

| | | |e |Net balance (3c – 3d) |3e | |

| | |4 |Asset in the case of others where proviso under section 112(1) exercised | |

| | | |a |Full value of consideration |4a | | |

| | | |b |Deductions under section 48 | |

| | | | |i |Cost of|bi | |

| | | | | |acquisi| | |

| | | | | |tion | | |

| | | | | |without| | |

| | | | | |indexat| | |

| | | | | |ion | | |

| | | |d |Deduction under sections 54/54B/54D/54EC/54F/54G/ 54GA |4d | | |

| | | |e |Net balance |4e | |

| | |5 |Amount deemed to be long term capital gains under sections | |5 | |

| | | |54/54B/54D/54EC/54ED/54F/54G/ 54GA | | | |

| | |6 |Total long term capital gain (1e (enter nil if loss) + 2 + 3e (enter nil if loss) + 4e (enter nil if |B6 | |

| | | |loss) + 5) | | |

| |C |Income chargeable under the head “CAPITAL GAINS” (A6 + B6) (enter B6 as nil if loss) |C | |

| |D |Information about accrual/receipt of capital gain | | |

| | | |Date |up to 15/9 |16/9 to 15/12 |16/12 to 15/3 |16/3 to 31/3 |

| | | | |(i) |(ii) |(iii) |(iv) |

| | |1 |Long- term | | | | |

| | |2 |Short-term | | | | |

|NOTE |Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head |

Other Sources

|Schedule OS |Income from other sources |

| |1 |Income other than from owning race horse(s): - | |

| | |a |Dividends, Gross |1a | | |

| | |b |Interest, Gross |1b | | |

| | |c |Rental income from machinery, plants, buildings, |1c | | |

| | |d |Others, Gross (excluding income from owning race horses) |1d | | |

| | |e |Total (1a+1b+1c+1d) |1e | |

| | |f |Deductions under section 57: | |

| | | |i |Expenses |fi | | |

| | | |ii |Depreciation |fii | | |

| | | |iii |Total |fiii| | |

| | |g |Balance (1e-fiii) |lg | |

| |2 |Winnings from lotteries, crossword puzzles, races, etc |2 | |

| |3 |Income from other sources (other than from owning race horses) (1g + 2) (enter 1g as nil if loss) |3 | |

| |4 |Income from owning and maintaining race horses | |

| | |a |Receipts |4a | | |

| | |b |Deductions under section 57 in relation to (4) |4b | | |

| | |c |Bala| |

| | | |nce | |

| | | |(2a | |

| | | |– | |

| | | |2b) | |

|NOTE | Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head |

Losses

|Schedule CYLA |Details of Income after set off of current years losses |

| |Sl.No. |

| |Sl.|Head/ Source of |Income after set off, if|Brought forward loss set|Brought forward |Brought forward |Current year’s |

| |No |income |any, of current year’s |off |depreciation set off |allowance under |Income remaining after |

| | | |losses as per | | |section35 (4) set off |set off |

| | | |5 of Schedule. CYLA | | | | |

| |I |House Property | | | | |

| |vii|Current year’s income remaining after set off Total (i5 + ii5 + iii5 + iv5+v5) | |

|Schedule CFL |Details of Losses to be carried forward to future Years |

| |Sl. |

| |No |

|1 |Deduction in respect of units located in Software Technology Park | |

| |a |Undertaking No.1 |1a | | |

| |b |Undertaking No.2 |1b | | |

| |c |Undertaking No.3 |1c | | |

| |d |Undertaking No.4 |1d | | |

| |e |Undertaking No.5 |1e | | |

| |f |Total (1a + 1b+ 1c + 1d + 1e) |1f | |

|2 |Deductions in respect of units located in Electronic Hardware Technology Park | |

| |a |Undertaking No.1 |2a | | |

| |b |Undertaking No.2 |2b | | |

| |c |Undertaking No.3 |2c | | |

| |d |Total (2a + 2b+ 2c) |2d | |

|3 |Deductions in respect of units located in Free Trade Zone | |

| |a |Undertaking No.1 |3a | | |

| |b |Undertaking No.2 |3b | | |

| |c |Undertaking No.3 |3c | | |

| |d |Total (3a + 3b+ 3c) |3d | |

|4 |Deductions in respect of units located in Export Processing Zone | |

| |a |Undertaking No.1 |4a | | |

| |b |Undertaking No.2 |4b | | |

| |c |Undertaking No.3 |4c | | |

| |d |Total (4a + 4b+ 4c) |4d | |

|5 |Deductions in respect of units located in Special Economic Zone | |

| |a |Undertaking No.1 |5a | | |

| |b |Undertaking No.2 |5b | | |

| |c |Undertaking No.3 |5c | | |

| |d |Total(5a+5b+5c) |5d | |

|6 |Total of deduction under section10A (1f +2d +3d+ 4d+ 5d) |6 | |

|Schedule 10AA |Deduction under section 10AA |

|Deductions in respect of units located in Special Economic Zone | |

|A |Undertaking No.1 |a | | |

|B |Undertaking No.2 |b | | |

|C |Undertaking No.3 |c | | |

|D |Total (a + b + c) |d | |

|Schedule 10B |Deduction under section 10B |

|Deduction in respect of hundred percent Export Oriented units | |

|A |Undertaking No.1 |a | | |

|B |Undertaking No.2 |b | | |

|C |Undertaking No.3 |c | | |

|D |Undertaking No.4 |d | | |

|E |Undertaking No.5 |e | | |

|F |Total (a + b + c + d + e) |f | |

|Schedule 10BA |Deduction under section 10BA |

|Deduction in respect of exports of hand-made wooden articles | |

|A |Undertaking No.1 |a | | |

|B |Undertaking No.2 |b | | |

|C |Undertaking No.3 |c | | |

|D |Undertaking No.4 |d | | |

|E |Undertaking No.5 |e | | |

|F |Total (a+b+c+d+e) |f | |

| Schedule 80G |Details of donations entitled for deduction under section 80G |

|A |Donations entitled for 100% deduction | |

| |Name and address of donee | |Amount of donation |

| | | | | |

| | | | | |

| | |Total |Avi | |

|B |Donations entitled for 50% deduction where donee not required to be approved under section 80G(5) (vi) | |

| |Name and address of donee | |Amount of donation |

| | | | | |

| | | | | |

| | |Total |Bvi | |

|C |Donations entitled for 50% deduction where donee is required to be approved under section 80G(5) (vi) | |

| |Name and address of donee |PAN of donee | |Amount of donation |

| | | | | | |

| | | | | | |

| | |Total |Cvi | |

|D |Total donations (Avi + Bvi + Cvi) |D | |

|Schedule 80-IA |Deductions under section 80-IA |

| |a |Deduction in respect of profits of an enterprise referred to in |a | | |

| | |section 80-IA (4)(i) [Infrastructure facility] | | | |

| |b |Deduction in respect of profits of an undertaking referred to in |b | | |

| | |section 80-IA (4)(ii) [Telecommunication services] | | | |

| |c |Deduction in respect of profits of an undertaking referred to in |c | | |

| | |section 80-IA (4)(iii) [Industrial park and SEZ s] | | | |

| |d |Deduction in respect of profits of an undertaking referred to in |d | | |

| | |section 80-IA (4)(iv) [Power] | | | |

| |e |Deduction in respect of profits of an undertaking referred to in |e | | |

| | |section 80-IA (4)(v) [Revival of power generating plant] and | | | |

| | |deduction in respect of profits of an undertaking referred to in | | | |

| | |section 80-IA(4)(vi) [Cross-country natural gas distribution network]| | | |

| |f |Total deductions under section 80-IA (a + b + c + d) |f | |

|Schedule 80-IB |Deductions under section 80-IB |

| |a |Deduction in respect of industrial undertaking referred to in section |a | | |

| | |80-IB(3) [Small-scale industry] | | | |

| |b |Deduction in respect of industrial undertaking located in Jammu & Kashmir |b | | |

| | |[Section 80-IB(4)] | | | |

| |c |Deduction in respect of industrial undertaking located in industrially |c | | |

| | |backward states specified in Eighth Schedule [Section 80-IB(4)] | | | |

| |d |Deduction in respect of industrial undertaking located in industrially |d | | |

| | |backward districts [Section 80-IB(5)] | | | |

| |e |Deduction in the case of multiplex theatre [Section 80- |e | | |

| | |IB(7A)] | | | |

| |f |Deduction in the case of convention centre [Section 80- IB (7B)] |f | | |

| |g |Deduction in the case of company carrying on scientific research [Section |g | | |

| | |80-IB(8A)] | | | |

| |h |Deduction in the case of undertaking which begins commercial production or|h | | |

| | |refining of mineral oil [Section 80-IB(9)] | | | |

| |i |Deduction in the case of an undertaking developing and building housing |i | | |

| | |projects [Section 80-IB(10)] | | | |

| |j |Deduction in the case of an undertaking operating a cold chain facility |j | | |

| | |[Section 80-IB(11)] | | | |

| |k |Deduction in the case of an undertaking engaged in processing, |k | | |

| | |preservation and packaging of fruits and vegetables [Section 80-IB(11A)] | | | |

| |l |Deduction in the case of an undertaking engaged in integrated business of |l | | |

| | |handling, storage and transportation of food grains [Section 80-IB(11A)] | | | |

| |m |Deduction in the case of an undertaking engaged in operating and |m | | |

| | |maintaining a rural hospital [Section 80- IB(11B)] | | | |

| |n |Total deduction under section 80-IB (Total of a to m) |n | |

80 Deductions

|Schedule 80-IC or 80- IE |Deductions under section 80-IC or 80-IE |

| |1 |Deduction in respect of industrial undertaking located in Sikkim |1 | |

| |2 |Deduction in respect of industrial undertaking located in Himachal Pradesh |2 | |

| |3 |Deduction in respect of industrial undertaking located in Uttaranchal |3 | |

| |4 |Deduction in respect of industrial undertaking located in North-East | |

| | |a |Assam |4a | | |

| | |b |Arunachal Pradesh |4b | | |

| | |c |Manipur |4c | | |

| | |d |Mizoram |4d | | |

| | |e |Meghalaya |4e | | |

| | |f |Nagaland |4f | | |

| | |g |Tripura |4g | | |

| | |h |Total of deduction for undertakings located in North-east (Total of 5a to 5g) |4h | |

| |5 |Total deduction under section 80-IC or 80-IE(1 + 2 + 3 + 4h) |5 | |

Deduction-VI-A

|Schedule VI-A |Deductions under Chapter VI- A (Section) |

| |a |80C | |j |80GGC | | |

| |b |80CCC | |k |80IA (f of | | |

| | | | | |Schedule 80-IA) | | |

| |c |80CCD | |l |80IAB | | |

| |d |80D | |m |80IB (n of | | |

| | | | | |Schedule 80-IB) | | |

| |e |80DD | |n |80IC/ 80-IE (5 of | | |

| | | | | |Schedule 80-IC/80IE) | | |

| |f |80DDB | |o |80ID/ 80JJA | | |

| |g |80 E | |p |80QQB | | |

| |h |80G | |q |80RRB | | |

| |i |80GG/GGA | |r |80U | | |

| |s |Total deductions under Chapter VI-A (Total of a to r) |s | |

|Schedule SPI |Income of specified persons(spouse, minor child etc) includable in income of the assessee |

|Sl No |Name of the person |PAN of person |Relationship |Nature of income |Amount (Rs) |

| | | | | | |

| | | | | | |

|Schedule SI |Income chargeable to Income tax at special rates IB [Please see instruction Number-9(iii) for section code and rate of tax ] |

| |Sl. |Section code |_ |

| |No | | |

Firms’ Information

|Schedule IF |Information regarding partnership firms in which you are partner |

|Number of firms in which you are partner | |

|Sl |Name of the firm |PAN of the firm |Percentage Share in the |Amount of share in the |Capital balance on 31st |

|No | | |profit of the firm |profit |March in the firm |

| | | | | | |

| | | | | | |

| |Total | | |

Exempt Income

|Schedule EI |Details of Exempt Income (Income not to be included in Total Income) |

| |1 |Interest income |1 | |

| |2 |Dividend income |2 | |

| |3 |Long-term capital gains on which Securities Transaction Tax is paid |3 | |

| |4 |Net Agriculture income (other than income to be excluded under rule 7, 7A, 7B or 8) |4 | |

| |5 |Share in the profit of firm/AOP etc. |5 | |

| |6 |Others including exempt income of minor child |6 | |

| |7 |Total (1+2+3+4+5+6) |7 | |

|Schedule AIR |Other Information (Information relating to Annual Information Return) [Please see instruction number 9(iv) for code] |

|Sl |Code of Transaction |

|Sl |Name of Bank & Branch |BSR Code |Date of Deposit |Serial Number of |Amount (Rs) |

|No | | |(DD/MM/YYYY) |Challan | |

| |Advance Tax | | | | |

| | | | | | |

| | | | | | |

| |Self Assessment Tax | | | | |

| | | | | | |

| | | | | | |

|NOTE |Enter the totals of Advance tax and Self Assessment tax in Sl No. 11a & 11d of Part B-TTI |

|Schedule TDS1 |Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)] |

|Sl |Tax Deduction Account Number (TAN) of the |

|No |Employer |

|Sl |Tax Deduction Account |

|No |Number (TAN) of the |

| |Deductor |

|Schedule TCS |Details of Tax Collected at Source [As per Form 27D issued by the Collector(s)] |

|Sl |Tax Deduction and Tax Collection Account Number of the Collector |

|No | |

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